Circulation, Vol 83, 902-912, Copyright © 1991 by American Heart Association
HA Katus, A Remppis, FJ Neumann, T Scheffold, KW Diederich, G Vinar, A Noe, G Matern and W Kuebler
BACKGROUND. The present study was designed to evaluate the efficiency of a
newly developed troponin T enzyme immunoassay for the detection of acute
myocardial infarction. METHODS AND RESULTS. The study comprised 388
patients admitted with chest pain and suspected myocardial infarction and
101 patients with skeletal muscle damage and additional suspected
myocardial cell damage. Troponin T was elevated to more than twice the
analytical sensitivity of the assay (0.5 microgram/l) in all patients with
non-Q wave (range, 1.2-5 micrograms/l) and Q wave infarction (range, 3-220
micrograms/l). Troponin T appeared in serum as early as 3 hours after onset
of pain in 50% of the patients and remained elevated in all patients for
more than 130 hours, revealing release kinetics of both free cytosolic and
structurally bound molecules. The diagnostic efficiency of troponin T was
superior to that of creatine kinase-MB (98% versus 97%) and remained at 98%
until 5.5 days after admission, if patients with unstable angina were
excluded from analysis. In the 79 patients with unstable angina, troponin T
was elevated (range, 0.55-3.1 micrograms/l) in at least one blood sample
from each of 37 patients (56%). Circulating troponin T was correlated to
the presence of reversible ST segment or T wave changes on the
electrocardiogram (p less than 0.005) and to the frequency of in- hospital
complications. In the 101 patients with skeletal muscle damage and
suspected additional cardiac muscle damage, troponin T was the most useful
test; its efficiency was 89% or 94% (depending on the discriminator value
used) as compared with 63% for creatine kinase-MB. CONCLUSIONS. Thus, the
data of the study indicate that the newly developed troponin T test
improves the efficiency of serodiagnostic tools for the detection of
myocardial cell necrosis as compared with conventionally used cardiac
enzymes.
ARTICLES
Diagnostic efficiency of troponin T measurements in acute myocardial infarction
Innere Medizin III, University of Heidelberg, FRG.
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A.A Lotto, M Caputo, R Ascione, C.T Lloyd, V Lucchetti, and G.D Angelini Evaluation of myocardial metabolism and function during beating heart coronary surgery Eur. J. Cardiothorac. Surg., September 1, 1999; 16(suppl_1): S112 - S116. [Abstract] [Full Text] [PDF]
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T. M. Hurst, M. Hinrichs, C. Breidenbach, N. Katz, and B. Waldecker Detection of myocardial injury during transvenous implantation of automatic cardioverter-defibrillators J. Am. Coll. Cardiol., August 1, 1999; 34(2): 402 - 408. [Abstract] [Full Text] [PDF]
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A. H.B. Wu, F. S. Apple, W. B. Gibler, R. L. Jesse, M. M. Warshaw, and R. Valdes Jr. National Academy of Clinical Biochemistry Standards of Laboratory Practice: Recommendations for the Use of Cardiac Markers in Coronary Artery Diseases Clin. Chem., July 1, 1999; 45(7): 1104 - 1121. [Abstract] [Full Text] [PDF]
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G. Schett, B. Metzler, R. Kleindienst,, A. Amberger, H. Recheis, Q. Xu, and G. Wick Myocardial injury leads to a release of heat shock protein (hsp) 60 and a suppression of the anti-hsp65 immune response Cardiovasc Res, June 1, 1999; 42(3): 685 - 695. [Abstract] [Full Text] [PDF]
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M. C. Kontos, R. L. Jesse, F. P. Anderson, K. L. Schmidt, J. P. Ornato, and J. L. Tatum Comparison of Myocardial Perfusion Imaging and Cardiac Troponin I in Patients Admitted to the Emergency Department With Chest Pain Circulation, April 27, 1999; 99(16): 2073 - 2078. [Abstract] [Full Text] [PDF]
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J. Zimmerman, R. Fromm, D. Meyer, A. Boudreaux, C.-C. C. Wun, R. Smalling, B. Davis, G. Habib, and R. Roberts Diagnostic Marker Cooperative Study for the Diagnosis of Myocardial Infarction Circulation, April 6, 1999; 99(13): 1671 - 1677. [Abstract] [Full Text] [PDF]
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F. Van Lente, E. S. McErlean, S. A. DeLuca, W. F. Peacock, J. S. Rao, and S. E. Nissen Ability of troponins to predict adverse outcomes in patients with renal insufficiency and suspected acute coronary syndromes: a case-matched study J. Am. Coll. Cardiol., February 1, 1999; 33(2): 471 - 478. [Abstract] [Full Text] [PDF]
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L. Holmvang, M. S. Luscher, P. Clemmensen, K. Thygesen, and P. Grande Very Early Risk Stratification Using Combined ECG and Biochemical Assessment in Patients With Unstable Coronary Artery Disease (A Thrombin Inhibition in Myocardial Ischemia [TRIM] Substudy) Circulation, November 10, 1998; 98(19): 2004 - 2009. [Abstract] [Full Text] [PDF]
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R. Roberts and R. E. Fromm Management of Acute Coronary Syndromes Based on Risk Stratification by Biochemical Markers : An Idea Whose Time Has Come Circulation, November 3, 1998; 98(18): 1831 - 1833. [Full Text] [PDF]
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M GALIÑANES In search of a reliable marker of tissue injury during heart surgery Heart, October 1, 1998; 80(4): 317 - 318. [Full Text]
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T W Koh, J Hooper, M Kemp, F D Ferdinand, D G Gibson, and J R Pepper Intraoperative release of troponin T in coronary venous and arterial blood and its relation to recovery of left ventricular function and oxidative metabolism following coronary artery surgery Heart, October 1, 1998; 80(4): 341 - 348. [Abstract] [Full Text]
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T. A Abdel Aziz, N. Al Khaja, M. A Ali, A. S Maklad, M. F Bassiouny, M. Turner, and D. G Roberts Antegrade-Retrograde Cardioplegia for Myocardial Protection During Coronary Artery Bypass Graft Surgery Asian Cardiovasc Thorac Ann, September 1, 1998; 6(3): 188 - 194. [Abstract] [Full Text] [PDF]
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A C R Rao, P O Collinson, R Canepa-Anson, and S P Joseph Troponin T measurement after myocardial infarction can identify left ventricular ejection of less than 40% Heart, September 1, 1998; 80(3): 223 - 225. [Abstract] [Full Text]
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T. J. Dengler, R. Zimmermann, K. Braun, M. Muller-Bardorff, J.o. Zehelein, F.-U. Sack, P. A. Schnabel, W. Kubler, and H. A. Katus Elevated serum concentrations of cardiac troponin T in acute allograft rejection after human heart transplantation J. Am. Coll. Cardiol., August 1, 1998; 32(2): 405 - 412. [Abstract] [Full Text] [PDF]
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R. H. Christenson and H. M. E. Azzazy Biochemical markers of the acute coronary syndromes Clin. Chem., August 1, 1998; 44(8): 1855 - 1864. [Abstract] [Full Text] [PDF]
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L. Coudrey The Troponins Arch Intern Med, June 8, 1998; 158(11): 1173 - 1180. [Full Text] [PDF]
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A. H. B. Wu, Y.-J. Feng, R. Moore, F. S. Apple, P. H. McPherson, K. F. Buechler, G. Bodor, f. t. A. A. for, and C. C. S. o. c. Standardization Characterization of cardiac troponin subunit release into serum after acute myocardial infarction and comparison of assays for troponin T and I Clin. Chem., June 1, 1998; 44(6): 1198 - 1208. [Abstract] [Full Text] [PDF]
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O. Hetland and K. Dickstein Cardiac Troponin T by Elecsys System and a Rapid ELISA: Analytical Sensitivity in Relation to the TropT (CardiacT) ""Bedside"" Test Clin. Chem., June 1, 1998; 44(6): 1348 - 1350. [Full Text] [PDF]
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C. Haller, J. Zehelein, A. Remppis, M. Muller-Bardorff, and H. A. Katus Cardiac troponin T in patients with end-stage renal disease: absence of expression in truncal skeletal muscle Clin. Chem., May 1, 1998; 44(5): 930 - 938. [Abstract] [Full Text] [PDF]
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R. H. Christenson, S.-H. Duh, L. K. Newby, E. M. Ohman, R. M. Califf, C. B. Granger, S. Peck, K. S. Pieper, P. W. Armstrong, H. A. Katus, et al. Cardiac troponin T and cardiac troponin I: relative values in short-term risk stratification of patients with acute coronary syndromes Clin. Chem., March 1, 1998; 44(3): 494 - 501. [Abstract] [Full Text] [PDF]
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K. Suzuki, Y. Sawa, K. Kadoba, T. Takahashi, H. Ichikawa, K. Kagisaki, T. Ohata, and H. Matsuda Early Detection of Cardiac Damage With Heart Fatty Acid-Binding Protein After Cardiac Operations Ann. Thorac. Surg., January 1, 1998; 65(1): 54 - 58. [Abstract] [Full Text] [PDF]
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